Journal
JOURNAL OF CANCER
Volume 12, Issue 21, Pages 6445-6453Publisher
IVYSPRING INT PUBL
DOI: 10.7150/jca.63813
Keywords
breast cancer; elderly patients; age-related; metastasis; prognosis
Categories
Funding
- National Natural Science Foundation of China [82002551, 81772619]
- Science and Technology Project of Tianjin Municipal Health Commission [KJ20119]
- National Key Research and Development Program of China [2016YFC0901401]
- Bethune Charitable Foundation-Excelsior Surgical Fund [HZB-20190528-18]
- Clinical Trial Project of Tianjin Medical University [2017kylc006]
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Patients aged 80 years with breast cancer are less likely to accept cancer-related therapy and have the highest mortality rate among all patients, particularly those with liver metastasis.
Background: This study aimed to investigate the metastasis patterns and prognosis of breast cancer (BC) in patients aged >= 80 years with distant metastases, as the current literature lacks studies in this population. Methods: A retrospective, population-based study using data from the Surveillance, Epidemiology, and End Results (SEER) database was conducted to evaluate 36,203 patients with BC from 2010 to 2016. Patients were classified into three groups, the older group (aged >= 80 years), middle-aged group (aged 60-79 years), and younger group (aged < 60 years). The role of age at the time of BC diagnosis in metastasis patterns was investigated, and the survival of different age groups of patients with BC was assessed. Results: Overall, 4,359 (12%) patients were diagnosed with BC at age >= 80 years, 19,688 (54%) at 60-79 years, and 12,156 (34%) at < 60 years. Compared with the other two groups, those in the older group had a lower rate of treatment acceptance. Statistical analysis revealed that older patients were more likely to have lung invasion only (odds ratio [OR]: 1.274, 95% confidence interval [CI]: 1.163-2.674) and less likely to have bone invasion only (OR: 0.704, 95% CI: 0.583-0.851), brain invasion only (OR: 0.329, 95% CI: 0.153-0.706), or multiple metastatic sites (OR: 0.361, 95% CI: 0.284-0.458) compared to the other two groups. Age at diagnosis was an independent prognostic factor for survival. The older group had the worst overall survival (OS, P<0.001) and BC-specific survival (CSS, P<0.001). Furthermore, patients aged 80 years with only liver metastasis had the worst CSS and OS. Conclusion: Patients aged 80 years were less likely to be receptive to cancer-related therapy and had the highest cancer mortality rate among all patients. Our findings will hopefully help clinicians develop more appropriate modalities of cancer treatment in elderly BC patients.
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